Individual provider Active NPI

Carolyn Lee Moskonas

  • Massage Therapist
  • West Allis, WI
National Provider Identifier
1700547387
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
15684 Issued in WI
Practice address
6767 W Greenfield Ave # LL3
West Allis, WI 53214-4967
Phone
(414) 274-9621
NPI assigned
Jan 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 15684 WI Primary

Addresses

Primary practice location

6767 W Greenfield Ave # LL3
West Allis, WI 53214-4967

Mailing address

6767 W Greenfield Ave Ste LL3
West Allis, WI 53214-4967
Phone (414) 274-9621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
15684WIMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Milwaukee Reiki, LLC Massage Therapist CurrentSince Jan 17, 2022 Accepting new patients

Locations

6767 W Greenfield Ave
Ste LL3
West Allis, WI 53214
Phone (414) 274-9621

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1641340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1700547387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6767 W GREENFIELD AVE STE LL3",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532144967",
            "telephone_number": "414-274-9621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6767 W GREENFIELD AVE # LL3",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532144967",
            "telephone_number": "414-274-9621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSKONAS",
        "first_name": "CAROLYN",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-05",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WI",
            "license": "15684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.